scholarly journals Passive Hip Range-of-Motion Values Across Sex and Sport

2018 ◽  
Vol 53 (6) ◽  
pp. 560-567 ◽  
Author(s):  
Jennifer A. Hogg ◽  
Randy J. Schmitz ◽  
Anh-Dung Nguyen ◽  
Sandra J. Shultz

Context:  Greater passive hip range of motion (ROM) has been associated with greater dynamic knee valgus and thus the potential for increased risk of anterior cruciate ligament injuries. Normative data for passive hip ROM by sex are lacking. Objective:  To establish and compare passive hip ROM values by sex and sport and to quantify side-to-side differences in internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), and total ROM (ROMTOT). Design:  Cross-sectional study. Setting:  Station-based, preparticipation screening. Patients or Other Participants:  A total of 339 National Collegiate Athletic Association Division I athletes, consisting of 168 women (age = 19.2 ± 1.2 years, height = 169.0 ± 7.2 cm, mass = 65.3 ± 10.2 kg) and 171 men (age = 19.4 ± 1.3 years, height = 200.0 ± 8.6 cm, mass = 78.4 ± 12.0 kg) in 6 sports screened over 3 years: soccer (58 women, 67 men), tennis (20 women, 22 men), basketball (28 women, 22 men), softball or baseball (38 women, 31 men), cross-country (18 women, 19 men), and golf (6 women, 10 men). Main Outcome Measure(s):  Passive hip ROM was measured with the athlete lying prone with the hip abducted to 20° to 30° and knee flexed to 90°. The leg was passively internally and externally rotated until the point of sacral movement. Three measures were averaged for each direction and leg and used for analysis. We compared ROMIR, ROMER, ROMTOT (ROMTOT = ROMIR + ROMER), and relative ROM (ROMREL = ROMIR − ROMER) between sexes and among sports using separate 2 × 6 repeated-measures analyses of variance. Results:  Women had greater ROMIR (38.1° ± 8.2° versus 28.6° ± 8.4°; F1,327 = 91.74, P < .001), ROMTOT (72.1° ± 10.6° versus 64.4° ± 10.1°; F1,327 = 33.47, P < .001), and ROMREL (1.5° ± 16.0° versus −7.6° ± 16.5°; F1,327 = 37.05, P < .001) than men but similar ROMER (34.0° ± 12.2° versus 35.8° ± 11.5°; F1,327 = 1.65, P = .20) to men. Cross-country athletes exhibited greater ROMIR (37.0° ± 9.3° versus 30.9° ± 9.4° to 33.3° ± 9.5°; P = .001) and ROMREL (5.9° ± 18.3° versus −9.6° ± 16.9° to −2.7° ± 17.3°; P = .001) and less ROMER (25.7° ± 7.5° versus 35.0° ± 13.0° to 40.2° ± 12.0°; P < .001) than basketball, soccer, softball or baseball, and tennis athletes. They also displayed less ROMTOT (62.7° ± 8.1° versus 70.0° ± 9.1° to 72.9° ± 11.9°; P < .001) than basketball, softball or baseball, and tennis athletes. Conclusions:  Women had greater ROMIR than men, resulting in greater ROMTOT and ROMREL. Researchers should examine the extent to which this greater bias toward ROMIR may explain women's greater tendency for dynamic knee valgus. With the exception of cross-country, ROM values were similar across sports. The clinical implications of these aberrant cross-country values require further study.

2019 ◽  
Vol 28 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Brett S. Pexa ◽  
Eric D. Ryan ◽  
Elizabeth E. Hibberd ◽  
Elizabeth Teel ◽  
Terri Jo Rucinski ◽  
...  

Context: Following a baseball pitching bout, changes can occur to glenohumeral range of motion that could be linked to injury. These effects are in part due to the posterior shoulder’s eccentric muscle activity, which can disrupt muscle contractile elements and lead to changes in muscle cross-sectional area (CSA), as measured by ultrasound. Objective: To assess changes in muscle CSA, and range of motion immediately before and after pitching, and days 1 to 5 following pitching. Design: Repeated measures. Setting: Satellite athletic training room. Patients: Ten elite college baseball pitchers participating in the fall season (age: 18.8 [1.2] y, height: 189.2 [7.3] cm, mass: 93.1 [15.3] kg, 8 starters, 2 long relievers). Intervention: A pitching bout of at least 25 pitches (63.82 [17.42] pitches). Main Outcome Measures: Dominant and nondominant infraspinatus CSA, as measured by ultrasound, and glenohumeral range of motion including internal rotation (IRROM), external rotation (ERROM), and total rotation range of motion (TROM) before pitching, after pitching, and days 1 to 5 following the pitching bout. Results: Dominant limb CSA significantly increased day 1 after pitching, and returned to baseline on day 2 (P < .001). Dominant and nondominant TROM did not change until day 5 (4.4°, P < .001) and day 3 (4.5°, P < .001), respectively, where they increased. Dominant IRROM was significantly decreased for 3 days (day 1: 1.9°, P < .001; day 2: 3.1°, P < .001; day 3: 0.3°, P < .001) following pitching and returned to baseline on day 4, with no such changes in the nondominant limb. Dominant external rotation significantly increased immediately post pitching (4.4°, P < .001) but returned to baseline by day 1. Conclusions: The results of the study demonstrate that infraspinatus CSA does not recover until 2 days following pitching, and IRROM does not recover until 4 days following pitching. Baseball pitching elicits damage to the posterior shoulder muscle architecture, resulting in changes to physical characteristics that last up to 4 days following pitching.


2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.


2021 ◽  
pp. 1-8
Author(s):  
Elena M. D’Argenio ◽  
Timothy G. Eckard ◽  
Barnett S. Frank ◽  
William E. Prentice ◽  
Darin A. Padua

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.


Author(s):  
Gretchen D. Oliver ◽  
Kyle Wasserberger ◽  
Anne de Swart ◽  
Kenzie Friesen ◽  
Jessica Downs ◽  
...  

Context Inadequate hip range of motion (ROM) and isometric strength (ISO) may interfere with energy flow through the kinetic chain and result in increased injury susceptibility. Objective To examine the relationship of hip ROM and ISO with energy flow through the trunk and pitching-arm segments during the windmill softball pitch in youth athletes. A subsequent purpose was to examine the relationship between energy flow and pitch speed. Design Descriptive laboratory study. Setting University research laboratory. Patients or Other Participants A sample of 29 youth softball pitchers (age = 11.2 ± 1.3 years, height = 155.0 ± 10.4 cm, mass = 53.2 ± 12.6 kg). Main Outcome Measure(s) Bilateral hip internal-rotation and external-rotation (ER) ROM and ISO were measured. Net energy outflow and peak rates of energy outflow from the distal ends of the trunk, humerus, and forearm were calculated for the acceleration phase of the windmill softball pitch, and pitch speed was measured. Results Regression analysis revealed an effect of drive-hip ER ISO on the net energy flow out of the distal ends of the trunk (P = .045) and humerus (P = .002). Specifically, increased drive-hip ER ISO was associated with increased net energy outflow from the trunk to the humerus and from the humerus to the forearm. No significant effects of hip ROM or other hip ISO measures were observed. Additionally, pitchers who achieved higher peak rates of distal outflow tended to achieve higher pitch speeds. Conclusions An association was present between drive-hip ER ISO and the net energy flow out of the distal ends of the trunk and humerus during the acceleration phase of the windmill softball pitch, emphasizing the importance of hip and lower body strength in executing the whole-body windmill pitch. Overall, energy-flow analysis is an interesting new way to analyze pitching mechanics and will aid in furthering our understanding of performance and injury risk in windmill softball pitching.


2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775210 ◽  
Author(s):  
Christopher L. Camp ◽  
John M. Zajac ◽  
Dave Pearson ◽  
Dean Wang ◽  
Alec S. Sinatro ◽  
...  

Background: Although restricted hip range of motion (ROM) is associated with an increased risk for injuries in baseball players, the evolution of hip ROM over the season remains undefined. Hypothesis: Hip ROM profiles would be symmetric between hips and positions (pitchers vs position players) but would decrease from preseason to postseason. Additionally, it was hypothesized that this decrease in motion would correlate with workload. Study Design: Cohort study; Level of evidence, 2. Methods: Bilateral hip ROM was assessed in 96 professional baseball players (54 pitchers, 42 position players) preseason and postseason. ROM comparisons were made between lead and trailing hips, pitchers and position players, and preseason and postseason measures. The change from preseason to postseason was correlated with player demographics and measures of workload for pitchers and position players. Results: Preseason hip ROM was symmetric between hips; however, pitchers demonstrated increased preseason lead hip internal rotation (IR) ( P = .018) and bilateral hip total ROM (TROM) ( P < .020) compared with position players. From preseason to postseason, position players lost 7° of external rotation (ER) ( P ≤ .005 ). In pitchers, the loss of IR correlated with increased pitches ( P = .016) and innings ( P = .037), while the loss of ER ( P = .005 ) and TROM ( P = .014) correlated with increasing mean fastball velocity. Workload for position players did not correlate with motion loss. Conclusion: Symmetric hip ROM profiles should be anticipated in baseball players; however, pitchers may have increased preseason IR and TROM and postseason ER and TROM relative to position players. Although loss of motion correlated with workload in pitchers, this was not the case for position players. Hip motion should be monitored over the course of the season. This is particularly true for pitchers who lose IR as workload increases, which may place them at a greater risk for injuries.


2021 ◽  
Author(s):  
Gretchen D. Oliver ◽  
Kyle Wasserberger ◽  
Anne de Swart ◽  
Kenzie Friesen ◽  
Jessica Downs ◽  
...  

Abstract Context:Inadequate hip range of motion (ROM) and isometric strength (ISO) may interfere with energy flow through the kinetic chain and result in increased injury susceptibility. Objective:To examine the relationship of hip ROM and ISO with energy flow through the trunk and pitching arm segments during the windmill softball pitch in youth athletes. A subsequent purpose was to examine the relationship between energy flow and pitch speed. Design:Descriptive laboratory study. Setting:University research laboratory. Participants:A sample of 29 youth softball pitchers (11.2±1.3 yrs.; 155.0±10.4 cm; 53.2±12.6 kg). Main Outcome Measure(s):Bilateral hip internal rotation (IR) and external rotation (ER) ROM and ISO were measured. Net energy outflow and peak rates of energy outflow from the distal ends of the trunk, humerus, and forearm were calculated for the acceleration phase of the windmill softball pitch, and pitch speed was measured. Results:Regression analysis revealed a significant effect of drive hip ER ISO on the net energy flow out of the distal ends of the trunk (p=0.045) and humerus (p=0.002). Specifically, increased drive hip ER ISO was associated with increased net energy outflow from the trunk to the humerus and from the humerus to the forearm. No significant effects of hip ROM or other hip ISO measures were observed. Additionally, pitchers who achieved higher peak rates of distal outflow tended to also achieve higher pitch speeds. Conclusions:There is an association between drive hip ER ISO and the net energy flow out of the distal ends of the trunk and humerus during the acceleration phase of the windmill softball pitch, emphasizing the importance of hip and lower body strength in the execution of the whole-body windmill pitch. Overall, energy flow analysis is an interesting new way to analyze pitching mechanics and will aid in further understanding of performance and injury risk in windmill softball pitching.


Hand ◽  
2020 ◽  
pp. 155894472093736
Author(s):  
Leeor S. Yefet ◽  
Doria Bellows ◽  
Marija Bucevska ◽  
Rebecca Courtemanche ◽  
Kim Durlacher ◽  
...  

Background: Our group previously developed an upper extremity repositioning (Sup-ER) protocol for brachial plexus birth injuries (BPBIs) that may improve supination and external rotation (ER) at 2 years of age. Questions were raised about the potential for the protocol to cause internal rotation (IR) deficits. The goal of this study was to explore the longer-term outcomes of the Sup-ER protocol and investigate IR/ER function. Methods: This prospective cross-sectional cohort study examined 16 children older than 4 years of age with significant enough BPBI to be treated with the Sup-ER protocol. Total shoulder and elbow function were assessed, including passive and active ranges of motion and strength of IR and ER. Results: Range of motion (ROM) for most active movements was decreased in the affected compared to unaffected arm. Notably, IR passive ROM was similar in the affected (78.7°) and unaffected arm (82.8°). External rotation strength of the affected arm was weaker (42.8 N) compared to the unaffected arm (57.9 N). IR strength had a greater deficit in the affected (43.2 N) arm compared to the unaffected arm (72.2 N), but both ER and IR showed less deficit than described in the literature. Conclusions: Despite differences in ranges of motion between the affected and unaffected arms, ROMs for the affected arm were comparable to the functional limits as reported in the literature. The Sup-ER protocol shows potential to optimize long-term shoulder rotation function in children with BPBI without compromising IR.


Author(s):  
Jessica Downs ◽  
Kyle Wasserberger ◽  
Gretchen D. Oliver

AbstractThough chronic overhand throwing is known to result in range of motion and strength adaptations, there is limited research regarding interventions for maintenance of these characteristics. Therefore, the purposes of this study were to explore the use of a pre-throwing protocol focusing on lumbopelvic-hip complex musculature in high school baseball players and examine its effects on shoulder and hip range of motion and isometric strength over the course of a season. Four exercises were added to the intervention team’s warm-up routine. The control and intervention teams’ passive bilateral hip and shoulder range of motion and isometric strength were assessed pre/post-season. A multivariate analysis of variance revealed significant differences in delta scores between the teams for multiple shoulder and hip range of motion and isometric strength variables. Key results were the intervention team lost significantly more stride hip external rotation but gained more isometric strength than the control team. The intervention team was also able to better maintain shoulder range of motion than the control team. Practitioners should use the results of this study and consider incorporating exercises that target lumbopelvic-hip complex musculature into their current training program.


2020 ◽  
Vol 35 (3) ◽  
pp. 145-152
Author(s):  
Carlie Huberman ◽  
Melissa Scales ◽  
Srikant Vallabhajosula

OBJECTIVES: To begin to establish normative data for shoulder range of motion (ROM) and strength in the circus acrobats and to compare these values based on age, sex, hand dominance, and acrobatic subgroup. METHODS: Active (AROM) and passive (PROM) of the full shoulder complex and PROM of the isolated glenohumeral joint were measured in 193 circus acrobats using standardized techniques for anterior elevation (flexion), posterior elevation (extension), lateral elevation (abduction), and external and internal rotation. Shoulder strength was measured using a hand-held dynamometer in all planes of motion. Measurements were taken twice and averaged. Mixed ANOVA were performed. One-sample t-tests were used to compare with general population. RESULTS: Several significant differences were noted between dominant and non-dominant sides, but not between the sex or age groups tested. Acrobats who did both aerial and ground acrobatics had significantly greater full shoulder complex flexion AROM than the aerial group, and AROM extension than the ground group. Circus acrobats had significantly greater AROM full shoulder complex extension, abduction, internal and external rotation, and shoulder strength than the general population. CONCLUSION: Overall, results from this cross-sectional study revealed that circus acrobats had greater shoulder strength and ROM than the general population, which could affect the way these patients should be treated in a clinical setting. Age and sex seemed to have minimal effects, but there was clearly an effect of hand dominance. Acrobats who train both aerial and ground acrobatics may have greater ROM in certain planes than those who train in only one type of discipline.


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